Patriota Adriane Farias, Guerra Gláucia Virgínia de Queiroz Lins, Souza Alex Sandro Rolland
Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil.
Centro de Atenção à Mulher, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil.
Rev Bras Ginecol Obstet. 2014 Jul;36(7):296-302. doi: 10.1590/so100-720320140004958.
To describe the perinatal outcomes after preterm premature rupture of membranes.
A retrospective cohort study was carried out at Instituto de Medicina Integral Prof. Fernando Figueira - IMIP from January 2008 to December 2012. A total of 124 preterm premature rupture of membranes singleton pregnancies, with gestational age <35, were included in the study. Pregnant women carrying fetuses with malformations, hypertensive syndromes, diabetes, or diagnosis of infections at admission were excluded. The pregnant women were hospitalized for conservative treatment with corticosteroids, antibiotics and tocolysis with nifedipine if necessary. The results are reported as frequency distributions and measures of central tendency and dispersion.
Seventeen patients (13.7%) had a gestational age of less than 24 weeks. Mean maternal age was 25.7 years, mean gestational age at the diagnosis of preterm premature rupture of membranes was 29 weeks, mean amniotic fluid index was 3.5 cm, and mean latency period was 10.5 days. Most patients went into spontaneous labor by the 30th week of pregnancy, and the rate of vaginal delivery was 88.2%. Chorioamnionitis was the most frequent maternal complication (34.7%). Neonatal sepsis was observed in 12% of patients, and the perinatal mortality rate was 21.5% for the group at or beyond the 24th week of gestation and 76.5% for the group with less than 24 weeks of gestational age.
A low maternal mortality rate was observed in preterm premature rupture of membranes; however, high rates of complications and perinatal death were observed, suggesting that other conduct protocols should be studied.
描述胎膜早破后的围产期结局。
2008年1月至2012年12月在费尔南多·菲盖拉综合医学研究所(IMIP)进行了一项回顾性队列研究。共有124例单胎妊娠胎膜早破、孕周<35周的孕妇纳入研究。排除入院时携带畸形胎儿、患有高血压综合征、糖尿病或诊断为感染的孕妇。孕妇住院接受保守治疗,必要时使用皮质类固醇、抗生素并使用硝苯地平进行保胎治疗。结果以频率分布以及集中趋势和离散度指标进行报告。
17例患者(13.7%)孕周小于24周。产妇平均年龄为25.7岁,胎膜早破诊断时的平均孕周为29周,平均羊水指数为3.5 cm,平均潜伏期为10.5天。大多数患者在妊娠第30周前自然临产,阴道分娩率为88.2%。绒毛膜羊膜炎是最常见的产妇并发症(34.7%)。12%的患者出现新生儿败血症,孕周在24周及以上组的围产儿死亡率为21.5%,孕周小于24周组为76.5%。
胎膜早破患者的产妇死亡率较低;然而,观察到并发症和围产儿死亡发生率较高,提示应研究其他治疗方案。